Seth Roberts and Circadian Therapy

A while back I noted that hypothyroidism is a circadian rhythm disorder and that dietary steps that restore circadian rhythms, like intermittent fasting and daytime eating, should be therapeutic (“Intermittent Fasting as a Therapy for Hypothyroidism,” Dec 1, 2010).

Many other disorders besides hypothyroidism feature disturbed circadian rhythms:

  • Sleeplessness and poor sleep
  • Depression, bipolar disorder, and other psychiatric disorders
  • Dyslipidemia, metabolic syndrome and obesity.
  • Neurodegenerative disorders

Circadian rhythm disruption also suppresses immune function and increases vulnerability to infectious disease.

Restoring or strengthening circadian rhythm may be therapeutic for all of these conditions. Even for healthy people, tactics for enhancing circadian rhythms may improve health.

Which brings us to Seth Roberts.

Seth Cured a Sleep Disorder With Circadian Therapy

Seth is a well-known blogger, a Paleo dieter and psychologist, author of  The Shangri-La Diet, and a great self-experimenter.

Seth recently gave a talk that tells the history of his self-experimentation.

It turns out he suffered from disturbed sleep for many years. He experimented to find cures for 10 years; nothing worked. But then he got a lead.

When a student suggested he eat more fruit, he started eating fruit for breakfast. His sleep got worse! This was exciting to Seth because it was, in 10 years, the first thing he tried that changed his sleep.

He had the idea of trying no breakfast. It turned out that skipping breakfast improved his sleep. One of his slides:

This directly supports our idea that intermittent fasting (confining eating to an 8-hour window each day) should be therapeutic for circadian rhythm disorders such as disturbed sleep and hypothyroidism.

But what’s exciting is that Seth continued his experiments to find other ways to improve his sleep. As a psychologist, he knew that human contact controls when we sleep: people are most awake at the times they have contact with other people, and asleep when isolated.

He knew that watching TV can have effects similar to socializing. So he tried watching Jay Leno one morning. He slept very well the next night.

It turns out that looking at human faces is almost as good as real socializing. Here is Seth’s data relating mood to whether he looked at faces:

Seth also tracked his mood over the course of the day. The response of mood to seeing pictures of human faces clearly followed a circadian (24-hour) rhythm:

Another thing that relates to circadian rhythms is exercise: we normally exercise during the day and rest at night.

For a scholar, the easiest way to exercise is to stand rather than sit (for instance, by working at a standing desk). Seth tried standing 9 hours a day – and it cleared his sleep problem!

Of course, standing is not a very strenuous exercise. Seth found that if he just stood on one leg, the effect was much more intense, and he could fix his sleep problem with only minutes of one-legged standing per day.

He also found that eating more animal food improved his sleep. It’s possible that animal fat may enhance circadian rhythms more than other foods.


I found this fascinating – because it adds more evidence regarding the centrality of circadian rhythms in health – and exciting, because it shows that simple tactics can be therapeutic for circadian rhythm disorders.

In the hypothyroidism post, I suggested the following tactics for improving circadian rhythms:

  • Light entrainment: Get daytime sun exposure, and sleep in a totally darkened room.
  • Daytime feeding: Eat during daylight hours, so that food rhythms and light rhythms are in synch.
  • Intermittent fasting: Concentrate food intake during an 8-hour window during daylight hours, preferably the afternoon. A 16-hour fast leading to lower blood sugar and insulin levels, and the more intense hormonal response to food that results from concentration of daily calories into a short 8-hour time window, will accentuate the diurnal rhythm.
  • Adequate carb intake: Eat at least 400 “safe starch” carbohydrate calories daily during the afternoon feeding window. Relative to a very low-carb diet, this will increase daytime insulin release and, by increasing insulin sensitivity, may reduce fasting insulin levels. It will thus enhance diurnal insulin rhythm.

To these, we can add several more based on Seth’s findings:

  • Looking at human faces: If you work at a computer, keep a window up that cycles among photos of faces, or shows a video of a talk show; keep photos of your family near your screen.
  • Standing: Work at a standing desk or, failing that, get in the habit of standing on one leg rather than two.
  • Animal fat: Eat a diet high in animal fats.

These tactics cured Seth’s sleep disorder. Might these tactics also cure or greatly improve other circadian rhythm disorders – including hypothyroidism and psychiatric disorders like depression and bipolar disorder? Could looking at human faces help the obese lose weight and improve their lipid profiles?

I don’t know but I’d certainly give these techniques a try before pharmaceutical drugs. I believe these techniques deserve clinical testing as therapies for all diseases associated with disrupted circadian rhythms. I believe that they may be just as beneficial for the healthy: by improving immune function, they may delay aging and extend lifespan.

A few weeks ago, when I posted a video of Don Rumsfeld defending the use of a standing desk (the same video was later linked by John Durant and Mark Sisson), I brashly stated, “There are few single life adjustments more likely to improve your health than working at a standing desk.”

Perhaps that statement wasn’t as exaggerated as it may have seemed!

Seth’s Talk

Leave a comment ?


  1. Thank you for this informative post. Somehow I missed the earlier one about IF and hypothyroidism.
    I suffer from hypothyroidism but it is not AI. I don’t have Hashimoto’s. Mine appears to have been caused by either adrenal fatigue, a very physically strenuous twin pregnancy or the very low-carb diet I followed for 2 years.
    I have 2 questions.
    1) Do you believe that the recommendations above regarding eating times and light exposure would be helpful to non-hashimoto’s hypothyroidism?
    2) Can the fasting window contain any calories at all? I’m not sure if I could give up my early morning coffee with cream. 😀

  2. Hi Emma,

    1) Yes, I do.
    2) Coffee with cream seems an excellent fasting breakfast!

  3. I’ve been trying to deal with adrenal fatigue for…it seems like forever, but some while. Intermittent fasting seems to really wreck my day. Is it something that gets better with time, or should I just hold off until I get the adrenal stuff working a bit better.

  4. Hi Sue,

    I haven’t investigated adrenal fatigue and fasting, so this is off the top of my head, but cortisol is involved in preventing hypoglycemia during fasting and adrenal fatigue reduces the ability to make cortisol. So I assume the trouble is that you become hypoglycemic when you fast.

    You might wish to obtain a glucose meter and test yourself to check that.

    If it’s the case, I would eat enough starch or glucose to avoid hypoglycemia. This doesn’t require much food. A banana supplies about 4 hours worth of glucose, so you could nibble on a banana over the course of the morning.

    So you might just try intermittent fasting with nibbling.

  5. Very interesting info Paul, thank you.

    I was wondering why I feel sleepy after lunch? To the point that if I start reading something after lunch I fall asleep and need to take a nap.
    I follow PHD, 15% protein, 25-30% carbs and 55-60% fats.
    It used to happen before I went Paleo/PHD but I just wrote if off to too much carbs. I’m confused why I still feel this way even if I eat just meat and veggies for lunch.
    I don’t know if it has anything to do with this, but I had my gallbladder taken out a few years ago.
    Sorry, my question is not exactly on topic:)

  6. Thanks for the video. I love Seth’s work but somehow missed it.

    In addition to improving health, I think standing helps me get more done: the minor discomfort tends to nudge me back to what I’m working on whenever my mind starts to wander. Maybe I have ADHD, or maybe sitting is just too darn comfortable!

  7. Nice summary of Seth’s work. His is one of the blogs I have followed for several years, always interesting stuff on there.

    What do you think about his taste-calorie association setpoint theory?

  8. I wanted to throw out coffee and caffeine intake as another possible circadian disruptor. I’m a probable slow caffeine metabolizer (per 23andme). So, I’m experimenting with cutting back to a single morning mug, and then will wean off that for a while, to see if sleep improves. I have a feeling that many, including myself, use coffee for mood boosting effects and possibly drink too much. I find it interesting that this topic gets skimmed over by many coffee drinking paleo enthusiasts. Oh, and I wish there was a less subjective method to collect sleep data. Has anyone tried the Zeo?

  9. Slightly OT here, but I’m inspired by the coffee commenters to throw this into the mix. There are some interesting connections between coffee (or stimulants in general) and ADD. If I suspect ADD, I will ask a patient to try to notice what happens when they take something with caffeine in it (coffee, tea, or their stimulant of choice). Chances are, rather than becoming jittery, they feel calmer and more steady. It just so happens that binge eating (or mindless eating in its many guises) is something that is not uncommon with folks who have ADD. It is a regular feature especially with women, who more often manifest with the under-stimulated variety of ADD. Since dopamine pathways are involved in ADD, some will reach for food to keep a threshold of pleasure/satiety going. Makes a lot of sense, since it’s well known that one of the main stimulants now used to treat ADD (amphetamine salts) used to be prescribed as a diet drug. I think there is also a circadian connection (though I’m not sure which is the chicken and which the egg) in the fact that most binge eating happens in the evening. I often recommend that patients try to interrupt a binge by engaging in some other self-soothing activity, but I hadn’t considered something like looking at pictures of faces of loved-ones. Since a binge also often involves watching TV, I try to work on ways to decouple eating and watching TV. It’s also easy to binge eat at night because the immediate consequences of a binge (uneasy GI symptoms, feelings of guilt and self-loathing) can be avoided by going to sleep. The cycle is very complicated, but there are many possible entry points for setting things back on track.

  10. This is a very interesting post. I used to do the 16/8 intermittent fasting protocol a while ago but I didn’t notice any effect on sleep but maybe that was why I wasn’t paying attention to it.

    I tried the shangri la method of reducing appetite once, and to my surprise it worked really well. What are your opinions on it?

  11. Hi Mia,

    Can you give a bit more information? Do you get sleepy after dinner and breakfast too, or only lunch? Do you eat breakfast, or is this only when intermittent fasting? If you ate the same at lunch and dinner, is the response different?

    Hi Tyler, Kris,

    The Shangri-La method sounded crazy the first time I heard it, but you can’t argue with experience, and now I think it’s true and very, very cool. Biology really can work that way.

    Everyone has seen people say “I’m stuffed” after dinner, but then have room for dessert. Clearly something about flavor affects desire and willingness to eat. Seth’s idea that this could be manipulated for weight loss was really, really clever.

    Seth has another idea today – that the taste for dessert is really a taste for vitamin C.

    Hi stoic,

    My wife and I tried coffee last summer but gave up on it – she seems to be allergic to it. I didn’t notice strong effects, except that I had to dilute it with a lot of cream to cover the taste and the cream added a lot of calories to my diet and suppressed appetite.

    Hi Maggy,

    Fascinating. Look at Seth’s plot of mood – low mood is in the evening. Possibly that’s true of the binge eaters too, and the low mood triggers appetite.

    Appetite is a fascinating subject – it has so many variables influencing it, and seems so central to weight loss. It didn’t have to be that way. The ShangriLa diet might reduce appetite but not work as a weight loss strategy. But it seems to work.

  12. Last weekend I was searching online for ways to re-set the Circadian Rhythm because with rare exceptions I’ve been waking between 2am and 3am -ish for over 30 years. I found this statement in a 2008 article:

    “Scientists have long known that our 24-hour “circadian rhythm” is regulated by a group of cells in the hypothalamus region of the brain. These cells, which represent the body’s main clock, are sensitive to changes in light conditions registered through the optic nerve in the eye.

    Researchers at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston have now pinpointed a second clock that is set by the availability of food. Their study, published today in the journal Science, is based on research on mice. But they believe all mammals, including humans, possess an internal food clock, too.”

    Article at
    There’s an interview with one of the researchers at

    Great info as usual, Paul. Thanks also to the commenters for useful input.

    (that’s odd: commenter is a valid word, but commenters gets flagged by spell-check.)

  13. Paul this is a great post.

    I try to follow this approach but one issue I have is I do martial arts class (BJJ) in the mornings from 7-8 which can sometimes be pretty strenous. If I end of working really hard I’ve been having some coconut water afterwards with some BCAAs, and then have a meal a few hours later.

    Do you think the coconut water (similar to a banana) for some glucose would throw off the circadian benefits?

  14. I neglected to mention that, applying the Harvard group’s recommendation (stop eating 16-20 hours before desired wake-up time) would be the opposite of the kind of IF I’ve been doing. That is, to reset the internal clock for 6am, one would stop eating at 2pm.

    I’m going to try it to see what happens. Apparently they think it works pretty quickly to reset it.

  15. Hi Jim,

    Thanks much for the link. Did you notice the “biphasic sleep” stories a few weeks ago? Waking at 2 am may be healthful, as long as you go back to sleep easily!

    Hi Greg,

    I think that is fine but it does tend to set the “day” hours beginning at 7 am so you may want to avoid extending “day” activities too late into the evening.

  16. Funny timing.

    My girlfriend just got an ipad, we took it into bed to try watching netflix.

    We’re also on a no-drinking kick this week after a bad weekend. Paul, an interest in a PHD hangover cure?

    So, after starting at the screen for an hour or so we went to sleep. Both of us overslept this morning, and felt up feeling, yep, hungover.

    I’m blaming the LEDs.

  17. Hi Robert,

    I just installed F.lux on my computer, unfortunately it’s not yet available for iPads. Might be worth installing when it is.

    I’ll leave hangover cures for others! I’m not really interested in testing them out.

    Best, Paul

  18. Great post. Animal foods are also a much better source of B6 than plant foods, both because of amount and because of bioavailability:

    B6 is needed for the conversion of tryptophan to serotonin, which is in turn needed for the production of melatonin.

    Plant B6 tends to be bound in sugars and needs to be freed in the intestine, and there is a lot of variation in this step. Then it needs to be converted in a B2-dependent process in the liver into the active form. Cooking not only degrades B6 mildly but also causes the formation of compounds that interfere with B6 activity. According to the reviews I have read, cooking meat results in a 25-30 percent loss of activity and cooking soybeans results in a 40 percent loss of activity.

    Bananas are a particularly good plant source because most of their B6 is not sugar-bound and because they are usually eaten raw. Sufficient carbohydrate is also necessary to get tryptophan across the blood brain barrier, and banana’s have a nice dose of that.

    In any case, this would be a good explanation of why animal foods might boost mood and help with sleep.


  19. Hi Chris,


    B6 is a good idea. But Seth said animal fat specifically helped him – lard or bacon. I don’t know what the mechanism for that might be.

    Best, Paul

    • Hi Paul and Chris,

      He wrote about pork fat. Bacon is rich in tryptophan which produces melatonin.

      If we agree to this mechanism, would tryptophan-rich foods be better eaten at night?


  20. Hi Paul,

    Here is some more info.
    I only get sleepy after lunch. No problems after breakfast or dinner. I do eat breakfast every day.
    I feel like I might faint if I don’t:) So IF is out for me:) I’ve always had low blood pressure and I weigh ~108 lbs.
    Thank you

  21. Me too, I find coffee with cream to suppress my appetite, and yes, it can add a lot of calories!

    But, I like some coffee and cream for a fasting breakfast, then two meals later in the day.

  22. Hi Mia,

    The need for breakfast suggests hypoglycemia after a fast.

    The pattern of mid-day fatigue and fasting hypoglycemia is a pattern of adrenal fatigue. See e.g.

    You might ask your doctor or an endocrinologist to investigate adrenal and thyroid status, and also consider getting a glucose meter and looking for patterns in blood glucose levels.

    A lot of the hormones have a circadian rhythm, so it is most likely an endocrine issue. I think it’s worth looking into.

    Best, Paul

  23. Hi Paul,

    Thanks for the summary of Seth’s talk. I saw it mentioned at Conditioning Research, but hadn’t taken the time to watch it yet.

    Your post triggered me to go over to Seth’s site, where I found his self experimentation paper. In that he gives even more details of his sleep experiments, along with his weight loss experiments. A very interesting read.


  24. Interesting — most likely, in my view, the arachidonic acid for brain function, or the long-chain SFA and MUFA for satiety.


  25. Thank you very much Paul! I really appreciate your insight.
    I was suspecting hypoglycemia but didn’t think about adrenal fatigue. I’ll have to look into it.

  26. @Chris: Good reminder regarding B-6. I eat all of my animal foods raw so I guess I’m pretty stocked up on B-6 eating on average 2 pounds raw pastured chicken or raw WC-Salmon, 1 pound raw lamb liver, 3 dozen raw eggs and a dozen raw oysters or clams daily in addition to my proteolytic fruits, plantains, squashes and coconuts.

  27. “Relative to a very low-carb diet, this will increase daytime insulin release and, by increasing insulin sensitivity, may reduce fasting insulin levels.”

    Could you expand on that statement a bit more? how does it work?


  28. Hi remo,

    As carb intake increases, more glucose has to be disposed of. In order to dispose of it, more of the body (including skeletal muscle) becomes insulin sensitive. Once the dietary glucose is disposed of, high insulin sensitivity tends to produce hypoglycemia. To avoid that, insulin release goes to zero.

    So on the Kitavan diet, which is high carb but “safe starch” based, people develop very low fasting insulin levels.

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  30. Thank you for posting this really cool N=1 study. I can’remember that last time I slept without getting up at 3-4 am and usually waking a few times earlier. I have always been an early riser but only only in the last years had a problem with getting up before I am well rested.

    I am taking all of these tips and tomorrow I start eating in an 8 hour window (11-7 or 12-8)

    • Just wanted to check with you if the eating in an 8 hour window helped with early awakening? I had gone low carb and developed this irritating problem which I never had before! I have upped my carbs considerably and while that helped initially I’m back on the 4 am wake up again 🙁

  31. Thanks for posting a number of ways to reset the circadian rhythm. We have been trying to do that using dark therapy for my daughter who has bipolar disorder. I came across this useful link:
    with details on how it was used here:

    She is using amber glasses to block out blue light in the evening. For the last couple of years she had a clock radio/iPod docking station next to her bed with a bright blue display (now removed). It is amazing how much blue light is emitted from electronic devices (computers, TVs and indicator lights). We also got an amber night light to use in the bathroom to replace the LED (blue light-emitting) one.

    I am thinking that disrupted circadian rhythms can be a factor in adrenal dysregulation that seems to happen with some bipolars (see Eva Edelman’s Natural Healing for Bipolar ). My daughter’s cortisol levels were cycling strangely during the day, and other hormone cycling patterns during the month were also unusual. There was a case here: where there was cycling of hormones along with mood.

  32. Hi Kira,

    Thanks for those links. It makes sense that bipolar would be a circadian rhythm disorder. I hope the circadian therapies help your daughter recover.

    I’ll check out the Edelman book. Thanks much,


  33. There is also a tendency of many nutritionists and various specialists that breakfast is most important for regulating thyroid function, weight and energy utilization. It looks like body is most responsive to insulin in the morning so protein/fat is the best option and low CHO. Also, it makes body energized due to tyrosine from the protein part of the breakfast (from what I know tryptophan is not very well absorbed, its better to boost it via CHO during later hourse so to improve sleep via seratonin pathway)

    Most recommendations range from 30-70g of protein for breakfast.

    For instance

    The similar is mentioned in GCBC from Taubes and 4-Hour-Body by T. Ferris.

    What is your opinion?

  34. Hi maj,

    I think that’s a very reasonable point of view. Not sure that much protein is needed however. I think it can be a small amount of protein but protein a large share of the total energy, as in a few eggs (2 eggs = 12 g protein).

  35. Thx Paul

    It doesn’t fit well with 8-hour eating window system. Kruse even suggests that althoug IF is beneficial, you should never skip breakfast.

    I experimented with 50g protein breakfast to see if it can keep my appetite down during my job hours. Its very hard to get that amount of protein, I am already loosing the ideas (for instance 10g protein shake + 4 eggs + 2 hot dogs + some dairy). The results are as said so far – I don’t eat from 7:30 until 18 without much hunger. I snacked once and took 10g of almonds which completely satisfied me. The balancing of protein seem important. If I take less, I get hungry.

    I am not sure how good this is on the long run and how sustainable but it should promote autophagy and fix liver metabolism as there are no snacks. In between I only use lots of water, coffee and vitamin C.

  36. Hi maj,

    I guess I misunderstood, I eat a small breakfast including 1-2 eggs at the start of my 8 hour eating window. Do you become hypoglycemic in a 16 hour fast? Have you ever tested blood glucose levels?

    I really don’t think so much protein is needed. But I would be curious to hear your experience with different amounts of protein and hunger.

  37. No, no hypoglicemia. I didn’t test in last 2 months tho and I failed to find pharmacy that is willing to do it recently since I don’t own glucose meter myself.

    My blood glucose level is always between 5.1-5.4 mmol/l after IF type fast. This is the same as my morrning BG. I recently measured hbA1C which was 3.3%.

    My weight drops about 1kg (as water is lost). After introducing this, I feel great and energized on the way home and I feel like I want some sport activity. I am usually pretty hungry when I arrive at home.

    My only “problematic” lab result is now marginally lower MCV, otherwise all results are OK, I measure once a year and during this complete year I measured finger sugar frequently. On low carb start I had few days of hypoglicemia (3.6, 1 hour after protein meal, then upping to 5.1 for next 6 hours). Now, sugar is more or less stable, but I introduced this system of eating 10 days ago and since then didn’t measure.

    BMI=24.9, Age=34, Daily supplements (30mg LET CoQ10, ~400mg Mg via carbonated water, ~1mg Iodine via Kelp and water, 2-5 B. nuts, 8-12g vit. C, 2000IU vit D, 200 IU mixed tocopherols, 250-500 mg DHA/EPA, 1 multivit with 50mg Bs and chelated minerals).

    I’ll report my latest glucose levels as soon as possible. I will measure entire day – morning, 1 & 2h after breakfast, evening.

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  39. Hi Paul,
    I know this is an old post, but I’ve only recently found you via Dr. Mercola interview. (Wonderful by the way)

    I am having to do the intermittent fasting due to the fact I am severally metabolically damaged. My simple question is do you think it is okay to take the supplements in the morning? This is the best time for me, and I have been doing it for the past 2 mornings, and feel fine with this, even though that is a lot of supplements :D!

    I am a 50yrs, female, lifelong yo yoer, post menopausal, who could starve to death and not lose a pound. I am a good candidate for this experiment.

    I did order your book, but it will not get here for several weeks, and I am pumped to do this.

    Thank you for all you and your wife are doing, Rena.

  40. Hi Rena,

    Usually supplements are best taken with food, so if you are fasting in the morning then it would probably be better to put them in a bag and have them with lunch. However, if you prefer to take them in the morning, you might take a little bit of food, eg some yogurt, with them.

    Best, Paul

  41. Have you read research on how fasting 16 hrs when travelling long haul prevents jetlag? BBC did a horizon program on resetting the ‘body clock’s’ circadian rhythm in this way. A small experiment with 2 brothers who frequently fly to the US for work showed fasting virtually eliminated jetlag in the one that did not eat. The other one suffered jetlag as usual. See also:

    Thank you Paul en Shou-Ching for all your very good work!

  42. These are some interesting experiments. I am not a scientist, so could someone explain to me how I’m reading the charts wrong?

    It looks to me like he slept the best with fruit for breakfast and his mood fluctuated wildly on faces.

    Personally, I would rather have a calm, steady mood at 50% of maximum than be a manic-depressive basket case from looking at human faces too early in the morning.

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  45. Paul,

    Love your work and have a question about sleep. I understand the need and health benefits of 8-10 hours of sleep but in my current life situation and due to doctoral studies and work, some nights I only have a 6 hour block between getting home and having to wake up the next morning. This happens 2-3 times a week. On those days my mental function is decreased and my mood suffers. Do you have any suggestions on nutritional/lifestyle remedies to improve well-being even though I’m not getting enough sleep. I would also like to lose body fat and I know this makes it hard. On vacations, I generally sleep 9-10 so I know this is a huge sleep debt. Would appreciate any help. Thanks Paul!

    • I don’t think there are nutritional remedies for lost sleep. Lifestyle – if you could take a brief nap on days of lost sleep, that might help. Also, general circadian rhythm enhancement: get exercise outdoors in the sunshine every day, preferably both early morning and afternoon. Bright light during the day, dim lights at night. F.lux on the computer.

  46. Hi Paul,

    A little question about IF and circadian rythm.. Here, in France, we all change our clocks and watches by one hour, twice a year.. In winter, eating the last meal before sundawn is about 5 o’’s not sustainable with work or social life… What would be your best tip to make a 16 hours sustainable while maintaining skipping breakfast ? Is the 8 hours window time feeding the most important for circadian rythm or eating during ‘daytime”..?

    Your work makes my days better. Thanks so much.


    • Hi Maya,

      It’s OK to shift the eating period after dark in the winter. Just try to finish around 8 pm, and keep bright lights on until dinner is over. Give yourself a few hours with dim lights until bed.

  47. Hi!

    Happy New Year!

    One question: Whwn I’m hypothyroid, should I still eat the 400 carb calories or the 600 carb calories advised from your new Scribner’s edition?


  48. I told a friend of mine of working at a standing desk. But he has lordosis. Do you think it advisable standing for a longer period?


    • Hi JP,

      I am not an orthopedist so he should probably consult his doctor before doing it. But my guess would be that if he could develop the habit of turning his muscles “on” at 20% intensity routinely while standing, and take frequent breaks to get into bent postures, eg yoga child pose, then it might be beneficial.

      By “on” I mean squeezing his butt muscles together and tightening his abdominal muscles in in a way that lifts his rib cage and makes him stand taller.

      Strengthening muscles and improving mobility by hip-hingeing and other exercises might help too.

      Another thing he can do is have kneeling stands or chairs of several heights that he can put one foot on, so that he is not in extension all the time.

      A standing desk is not itself a cure-all, one needs a diversity of movements and postures and work against resistance or gravity for the body to be completely well. But I think it is generally better to stand and be free to move than to sit and slouch.

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